title: Effect of psychostimulants on brain structure and function in ADHD: a qualitative literature review of magnetic resonance imaging-based neuroimaging studies.
abstract: OBJECTIVE
  To evaluate the impact of therapeutic oral doses of stimulants on the brains of ADHD subjects as measured by magnetic resonance imaging (MRI)-based neuroimaging studies (morphometric, functional, spectroscopy).
  
  
  METHODS
  We searched PubMed and ScienceDirect through the end of calendar year 2011 using the keywords (1) psychostimulants or methylphenidate or amphetamine, and (2) neuroimaging or MRI or fMRI, and (3) ADHD or ADD or attention-deficit/hyperactivity disorder or attention deficit hyperactivity disorder.
  
  
  METHODS
  We included only English language articles with new data from case-control or placebo controlled studies that examined attention-deficit/hyperactivity disorder (ADHD) subjects on and off psychostimulants (as well as 5 relevant review articles).
  
  
  METHODS
  We combined details of study design and medication effects in each imaging modality.
  
  
  RESULTS
  We found 29 published studies that met our criteria. These included 6 structural MRI, 20 functional MRI studies, and 3 spectroscopy studies. Methods varied widely in terms of design, analytic technique, and regions of the brain investigated. Despite heterogeneity in methods, however, results were consistent. With only a few exceptions, the data on the effect of therapeutic oral doses of stimulant medication suggest attenuation of structural and functional alterations found in unmedicated ADHD subjects relative to findings in controls.
  
  
  CONCLUSIONS
  Despite the inherent limitations and heterogeneity of the extant MRI literature, our review suggests that therapeutic oral doses of stimulants decrease alterations in brain structure and function in subjects with ADHD relative to unmedicated subjects and controls. These medication-associated brain effects parallel, and may underlie, the well-established clinical benefits.
authors.affiliation: Massachusetts General Hospital, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, 55 Fruit St-WRN 705, Boston, MA 02114 Spencer@helix.mgh.harvard.edu.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Spencer
authors.forename: Ariel
authors.initials: A
authors.lastname: Brown
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Seidman
authors.forename: Eve M
authors.initials: EM
authors.lastname: Valera
authors.forename: Nikos
authors.initials: N
authors.lastname: Makris
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lomedico
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
mesh_terms: D000293:Adolescent; D000328:Adult; D000661:Amphetamine / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000661:Amphetamine